How Case Managers Can Work with Interpreters – Part II

In Part II of case managers and interpreters working together, I highlight a few misunderstood points.

Accuracy: The principle is that “Interpreters strive to render the message accurately, conveying the content and spirit of the original message, taking into consideration the cultural context.” Some case managers are annoyed and confused when I repeat the same thing over and over again. The reality is that the interpreter has to repeat everything that is being said, even if it is redundant or rude. As an interpreter, I must be complete and not omit anything.

Included under this principle is another issue. Sometimes, a case manager that I have known for a long time will begin to talk to me in private about something unrelated. This is where I have to use judgment. If it’s just a story about something that happened to her daughter at a Clemson game, I will probably repeat it to the patient and the case manager will remember I always repeat everything. If it obviously is something confidential, I will probably recommend that we not speak about that now since I must repeat everything. At that moment, I probably wouldn’t repeat some of what was said. Case managers, a basic guideline to remember is that the interpreter must repeat everything. Hence, if you don’t want it repeated, don’t say it in front of the patient.

Patients tend to think that everyone is talking about them and that most likely there is an insurance company conspiracy against them. When I repeat the corny jokes, family stories, and experiences, it calms the patient down just knowing that the conversation isn’t about her.

Another thought regarding impartiality. I have on occasion raised alarms by removing myself from interpreting in some cases. The guideline says “the interpreter discloses potential conflicts of interest, withdrawing from assignments if necessary.” Sometimes if I have spent many hours with patients, they become overly familiar with me. I might maintain my professionalism, but as far as they are concerned I have become their friend. When they begin to disregard and test the boundaries of my impartiality, I remove myself from that assignment, especially if they keep asking my opinion or advice on their medical issues.

Respect: “Interpreters treat all parties with respect.” Under that category is a guideline that says “the interpreter promotes direct communication among all parties in the encounter.” So this is what happens. The case manager will look at me and say, “Ask Mr. Rodriguez how he is feeling.” Mr. Rodriguez will look at me and say, “Tell her that I’m in pain!” It is common for the same scenario to happen with the doctor and nurses. The interpreter becomes the center of attention and there is no personal relationship between the patient and the others with whom he is communicating . As an interpreter, my job is transparency. Please look directly at the patient and speak to him. I will definitely repeat everything you say, and the result will be better communication and respect. People need to look into each other’s eyes if there is going to be trust.

Part III will conclude with a few final issues of which case managers should be aware.